ANTT What is it and do you need to know? Grampians Region Infection Control Group Sue Atkins Regional Infection Control Consultant
Aseptic Non Touch Technique Yes you need to know!
Introduction Understanding how microbes are transmitted, and knowing when and how to apply the basic principles of infection prevention and control, applies to everyone providing assistance/ care to someone at home, in the community, or in a healthcare facility. Infection prevention is everybody s business!
Standard Precautions Hand hygiene Respiratory hygiene and cough etiquette Personal protective equipment Appropriate handling and disposal of sharps Use of environmental controls Appropriate reprocessing of reusable items Use of aseptic non-touch technique-antt Appropriate handling of waste and linen
Aseptic Non Touch Technique An aseptic technique aims to prevent pathogenic organisms, insufficient quantity to cause infection, from being introduced to susceptible sites by hands, surfaces or equipment Aseptic non touch technique is used to prevent contamination of Key-Parts and Key-Sites by microorganisms that could cause infection
Aseptic Non Touch Technique In aged, residential or supported care aseptic non touch technique would be used in the following procedures/task examples: wound care eye care peg tube site management urinary catheter bag management leg bag to overnight bag supra-pubic catheter management medication preparation and administration
ANTT Terminology An understanding of ANTT begins with recalling the definitions of three important terms: 1. sterile 2. asepsis 3. clean
Sterile free from micro-organisms. Due to the significant volume of organisms in the atmosphere, it is not possible to achieve a sterile technique in a typical healthcare setting. Near sterile techniques can only be achieved in controlled environments such as a specially equipped theatre.
Asepsis freedom from infection or infectious (pathogenic) material. An aseptic technique aims to prevent pathogenic organisms, in sufficient quantity to cause infection, from being introduced to susceptible sites by hands, surfaces and equipment. Therefore, aseptic techniques are possible and can be achieved in the typical hospital and community settings.
Clean free from dirt, marks or stains. Although cleaning followed by drying of equipment and surfaces can be very effective, it does not necessarily meet the quality standard of asepsis. However, the action of cleaning is an important component in helping render equipment and skin aseptic, especially when there are high levels of contamination that require removal or reduction. To be confident of achieving asepsis an application of a skin or hard surface disinfectant is required either during cleaning or afterwards.
Core Components of ANTT In ANTT, asepsis is ensured by identifying and then protecting Key-Parts and Key-Sites, by hand hygiene, using a non-touch technique and gloves, selecting the appropriate aseptic field, assessing environmental controls, and the sequence in which the procedure is performed. These are known as the core infection prevention and control components.
Core Components of ANTT 1. Key-Parts and Key-Sites Key-Parts must be identified and protected at all times. Aseptic Key- Parts must only come into contact with other Aseptic Key-Parts and/or Key-Sites. Such as the contents of a dressing pack (Key-Part) coming into contact with the wound (Key-Site), steri-strips (Key-Part) coming into contact with the wound (Key-Site).
Core Components of ANTT 2. Hand Hygiene Hands can be cleaned using soap and water or a waterless product. It is known that hand hygiene is not always correctly performed and that even correctly performed hand hygiene cannot always remove all infectious agents. Therefore, a non-touch technique - identifying Key-Parts and not touching them directly or indirectly - is a vital component of achieving asepsis.
Core Components of ANTT 3. Glove Use Gloves are single-use items. In ANTT, if it is necessary to touch Key- Parts or Key-Sites directly, sterile gloves are used to minimise the risk of contamination. Otherwise, non-sterile gloves are typically the gloves of choice.
Core Components of ANTT 4. Aseptic Fields Standard and Surgical Aseptic fields are important in providing a controlled aseptic working space to help promote or ensure the integrity of asepsis during clinical procedures. ANTT employs two types of aseptic fields that require different management depending on whether the primary purpose is to promote or ensure asepsis.
Core Components of ANTT 5. Environmental Controls Prior to aseptic procedures, healthcare workers must ensure that there are no avoidable nearby environmental risk factors. For example: In a facility, staff making a bed, patients using commodes or visitors within close proximity can pose a risk, and in the home, uncontrolled pets can pose a risk.
Core Components of ANTT 6. Sequencing ANTT practice is sequenced to ensure an efficient, logical and safe order of procedure events. For example performing hand hygiene before gathering equipment required for the ANTT procedure you are to perform.
Core Components of ANTT Lets recap the core infection prevention and control components. They are: 1. Key-Part and Key-Site identification and protection 2. Hand hygiene 3. Glove use 4. Aseptic Fields to ensure or promote asepsis 5. Environmental controls 6. Sequencing of procedure events
Standard ANTT Standard General Aseptic Field Micro-Critical Aseptic Fields essential Non sterile gloves Hand hygiene Standard precautions Non touch technique essential
General Aseptic Field General Aseptic Field (Promoting asepsis)
Micro-Critical Aseptic Field Micro-Critical Aseptic Fields essential in a Standard ANTT. Micro-Critical Aseptic Fields are covers, caps and packaging that help to protect the Key-Parts such as syringe caps, sheathed needles, covers or packaging on syringes or wound care products. The inside of these caps and covers or packaging have been sterilized and thus provide an optimum aseptic field for Key-Parts.
Standard ANTT Procedures managed with Standard ANTT will usually be technically simple, short in duration (approximately less than 20 minutes), and involve relatively few and small Key-Sites and Key-Parts. Standard ANTT requires a Main General Aseptic Field and non-sterile gloves. The use of Critical Micro-Aseptic Fields and a non touch technique is essential to protect Key-Parts and Key-Sites. Examples: Uncomplicated wound dressings Peg tube site management Eye toilet
Uncomplicated Wound Dressing in a Facility
References This introduction has largely been based on the national infection control guidelines listed below to ensure the content reflects healthcare in Australia. These guidelines can be accessed from the below web link. NHMRC. (2010). Australian guidelines for the prevention and control of infection in healthcare. Commonwealth of Australia. Sections B1.7 and B5.4. www.nhmrc.gov.au/node/30290/